High‐Dose‐Rate Brachytherapy in the Treatment of Recurrent and Residual Head and Neck Cancer

Glatzel, M.; Büntzel, Jens; Schröder, Dietmar; Küttner, K; Fröhlich, D

doi:10.1097/00005537-200208000-00008

Cited by 40 publications

(29 citation statements)

References 11 publications

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“…Salvage surgery is rarely curative and carries a 20 -40% risk of serious complications (Marcial et al, 1980;Rate et al, 1991). Similarly, many different salvage radiotherapy regimens have been used, including external beam, interstitial 'high-dose-rate' or 'lowdose-rate' brachytherapy (De Crevoisier et al, 1998;Puthawala et al, 2001;Glatzel et al, 2002). Although 20 -30% of patients may survive for 2 years, moderate to severe complications (including carotid blow-out) have been reported in 30 -40% of cases.…”

Section: Discussionmentioning

confidence: 99%

Interstitial photodynamic therapy as salvage treatment for recurrent head and neck cancer

et al. 2004

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Interstitial photodynamic therapy (IPDT) is a technique for applying photodynamic therapy (PDT) to internal tumours using light delivered via fibres inserted percutaneously. This phase I -II study assessed the safety and efficacy of IPDT for patients with persistent or recurrent head and neck cancer unsuitable for further treatment with surgery, radiotherapy or chemotherapy, recruited for 'last hope' salvage treatment. Patients were sensitised with 0.15 mg kg À1 mTHPC (meso-tetrahydroxyphenyl chlorin) 4 days prior to light delivery from fibres inserted directly into the target tumour (20 J per site at 652 nm) under image guidance. In all, 45 patients were treated. Nine achieved a complete response. Five are alive and free of disease 10 -60 months later. Symptomatic relief (mainly for bleeding, pain or tumour debulking) was achieved in a further 24. The median survival (Kaplan -Meier) was 16 months for the 33 responders, but only 2 months for the 12 nonresponders. The only serious complication was a carotid blow out 2 weeks after PDT. No loss of function was detected in nerves encased by treated tumours. Interstitial photodynamic therapy provides worthwhile palliation with few complications and occasional long-term survivors for otherwise untreatable advanced head and neck cancers. It is a treatment option worth adding to those available to integrated head and neck oncology teams.

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Section: Discussionmentioning

confidence: 99%

Interstitial photodynamic therapy as salvage treatment for recurrent head and neck cancer

et al. 2004

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“…Historically utilized most frequently in the treatment of gynecologic malignancies [21][22][23], BRT is now also an established therapeutic modality in the management of residual, recurrent and metastatic tumors of the head and neck region [15,16,[24][25][26][27][28][29]. EBRT of the sinonasal tract and nasopharynx may result in both acute and late toxicities due to secondary radiation exposure to the optic chiasm, optic nerve, orbit and brainstem, especially in the setting of prior skull base irradiation.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

“…Although toxicities associated with brachytherapy are relatively low in comparison to conventional EBRT, potential side effects are not negligible. Toxicities in the head and neck region may include subcutaneous fibrosis, mucositis, ulceration, infections, fistula formation and necrosis [25,31].…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Cesium-131 Brachytherapy Seeds for the Treatment of Sinonasal Carcinosarcoma: A Case Report and Literature Review

Kutler¹

2017

OHNS

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A 70-year old male with poor cognitive function presented to an outside hospital in November 2010 with recurrent left-sided epistaxis. This patient had a history significant for anaplastic oligoastrocytoma Patel KR, et al., J Otolaryng Head Neck Surg 2017, 3: Radiation-induced tumors of the skull base pose a significant treatment challenge. Temporary Brachytherapy (BRT) with Cesium-131(Cs-131) seeds is a novel therapeutic technique that holds significant potential for the achievement of local tumor control in patients with limited therapeutic options. MethodsWe report a 70 year-old patient with a history of anaplastic oligoastrocytoma who presented with recurrent left-sided epistaxis. Imaging and biopsy results revealed a high-grade carcinosarcoma of the paranasal sinuses and skull base. The Sinonasal Carcinosarcoma (SN-CS) was resected and the residual micro tumor was treated with Cs-131 BRT seeds attached to a vicryl mesh, which was removed 6 weeks later. ResultsFollow-up examination demonstrated no evidence of recurrence or metastasis for 9 months and the patient had an overall survival of 15 months after treatment with Cs-131 BRT. ConclusionTemporary BRT with Cs-131 seeds may play a pivotal role in achieving local tumor control and palliation in patients with aggressive skull base tumors who are precluded from receiving more extensive forms of radiotherapy.

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“…Brachytherapy allows the application of radiation doses with high precision and accuracy in a short period of time and minimizes the frequency of complications for the adjacent healthy tissue [9,10], expanding so the role of radiotherapy in the sensitive area of head region [8]. None of The difficult exposition of tumours of the sinonasal tract and nasopharynx in combination with the frequent inability to achieve a resection with removal of extended surrounding healthy tissue in the situation of advanced tumour disease resulting in generally poor prognosis of these patients has attracted the attention of the head and neck surgeons to brachytherapy [11].…”

Section: Discussionmentioning

confidence: 99%

Customized individual applicators for endocavitary brachytherapy in patients with cancers of the nasal cavity, sinonasal region and nasopharynx

Kadah

Niewald

Papaspyrou

et al. 2015

Eur Arch Otorhinolaryngol

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Brachytherapy has become an established therapeutic regimen for primary, persistent, recurrent and metastatic tumour disease in the head and neck region. This study presents the authors' preliminary experience with intracavitary brachytherapy by means of an individual silicone applicator in the treatment of patients with nasal, sinonasal, orbital and nasopharyngeal cancer. Between January 2001 and January 2013, twenty patients with cancer of the nasal cavity, the paranasal sinuses and nasopharynx underwent surgery and intracavitary brachytherapy with the aid of an individually manufactured silicone applicator in the Department of Otolaryngology, Head and Neck Surgery and in the Department of Radiotherapy and Radiooncology at the Saarland University Medical Center of Homburg, Germany. The tumour was localized in the nasal cavity/paranasal sinuses (15) affecting the orbit twice and the nasopharynx (5). There were 14 patients with squamous cell carcinoma, 2 patients with mixed tumours and one patient with adenocarcinoma, adenoid cystic carcinoma, mucosal melanoma or plasmocytoma. The majority of the patients presented with advanced disease (T3 or T4 tumours). In 18/20 patients, brachytherapy was performed as a boost technique, in the remaining two solely because of a previous radiation series. All surgical interventions were performed endonasally. Three to six weeks after surgery, a cast of the nasal cavity was created under general anaesthesia. Subsequently, an individual brachytherapy silicon applicator with two to four plastic tubes was manufactured. The radiation therapy was applied using the Ir-192 high-dose-rate-afterloading method (total dose 10-20 Gy) in two to five sessions, additionally in 18/20 patients a percutaneous radiotherapy with a total dose of 30-60 Gy was applied. After a mean duration of follow-up of 2 years, 7/20 patients experienced a local progression, 5/19 a regional recurrence in the neck nodes and 4/19 distant metastases. The 2-year survival was 57.3 %. No serious complications were reported. The silicone applicator was well tolerated by all patients. Because of the complexity of the sinonasal anatomy with the finding of mainly advanced tumours, the presented individual silicone brachytherapy applicator has proven to be useful and meaningful for endocavitary brachytherapy of malignancies of the nasal cavities, paranasal sinuses and nasopharynx.

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High‐Dose‐Rate Brachytherapy in the Treatment of Recurrent and Residual Head and Neck Cancer

Abstract: High-dose-rate brachytherapy proved to be an effective treatment modality in locoregional recurrent head and neck cancer. In cases with persistent or residual tumor after primary radiochemotherapy a local boost with brachytherapy can improve the chance of cure of tumor disease.

Cited by 40 publications

References 11 publications

Interstitial photodynamic therapy as salvage treatment for recurrent head and neck cancer

Interstitial photodynamic therapy as salvage treatment for recurrent head and neck cancer

Cesium-131 Brachytherapy Seeds for the Treatment of Sinonasal Carcinosarcoma: A Case Report and Literature Review

Customized individual applicators for endocavitary brachytherapy in patients with cancers of the nasal cavity, sinonasal region and nasopharynx

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